System and method for treating the structure of the human lens with a laser

• US 20070173794A1
• Filed: 01/20/2006
• Published: 07/26/2007
• Est. Priority Date: 01/20/2006
• Status: Active Grant

• Current Assignee: LensAR, Inc. (PDL BioPharma, Inc.)
• Original Assignee: LensAR, Inc. (PDL BioPharma, Inc.)
• Inventors: Gray, Gary, Pape, Dennis, Kuszak, Jerome, Frey, Rudolph
• Granted Patent: US 10,842,675 B2
• Time in Patent Office: Days
• US Class Current: 606/5
• CPC Class Codes: A61B 2018/20351 Scanning mechanisms
• CPC Class Codes: A61B 2018/20355 Special scanning path or conditions, e.g. spiral, raster or providing spot overlap
• CPC Class Codes: A61B 2018/20361 with redirecting based on sensed condition, e.g. tissue analysis or tissue movement
• CPC Class Codes: A61B 90/30 Devices for illuminating a surgical field, the devices having an interrelation with other surgical devices or with a surgical procedure
• CPC Class Codes: A61B 90/361 Image-producing devices, e.g. surgical cameras
• CPC Class Codes: A61F 2009/0087 Lens
• CPC Class Codes: A61F 2009/00887 Cataract
• CPC Class Codes: A61F 2009/00897 Scanning mechanisms or algorithms
• CPC Class Codes: A61F 9/00736 Instruments for removal of intra-ocular material or intra-ocular injection, e.g. cataract instruments A61F9/008 takes precedence
• CPC Class Codes: A61F 9/008 using laser
• CPC Class Codes: A61F 9/00834 Inlays; Onlays; Intraocular lenses [IOL]

Abstract

A system and method for increasing the amplitude of accommodation and/or changing the refractive power and/or enabling the removal of the clear or cataractous lens material of a natural crystalline lens is provided. Generally, the system comprises a laser, optics for delivering the laser beam and a control system for delivering the laser beam to the lens in a particular pattern. There is further provided a device for determining the shape and position of the lens with respect to the laser. There is yet further provided a method and system for delivering a laser beam in the lens of the eye in a predetermined shot pattern that utilize as series of shots that form a shell cut, a partial shell cut, a laser suture cut and/or a volumetric shaped removal, which essentially following the shape of a suture layer of the lens.

Claims

1. A method for delivering a laser beam to a lens of an eye comprising:

a. providing a laser;

b. providing an optical path for directing a laser beam from the laser to the lens of the eye;

c. determining the shape and position of the lens with respect to a fixed-point; and

,

d. focusing a laser beam to a location in the lens of the eye; and

,

e. said location being based at least in part upon the determinations of step c.

2. The method of claim 1 comprising the step of directing the laser beam in the lens of the eye in a predetermined shot pattern, said shot pattern comprising as series of shots that form a shell cut, said shell cut being positioned entirely within the lens and essentially following a layer shape of the lens.

3. The method of claim 1 comprising the step of directing the laser beam in the lens of the eye in a predetermined shot pattern, said shot pattern comprising as series of shots that form a partial shell cut, said partial shell cut being positioned entirely within the lens and essentially following a layer shape of the lens.

4. The method of claim 1 comprising the step of directing the laser beam in the lens of the eye in a predetermined shot pattern, said shot pattern comprising as series of shots that form a laser suture cut, said cut being positioned entirely within the lens, and essentially following a layer shape of the lens.

5. The method of claim 1 comprising the step of directing the laser beam in the lens of the eye in a predetermined shot pattern, said shot pattern comprising as series of shots that form a volumetric shaped removal, said volumetric shaped removal being positioned entirely within the lens and essentially following a layer shape of the lens.

6. The method of claim 1 comprising the step of directing the laser beam in a shot patter to from an annular ring shaped capsulorhexis.

7. The method of claim 1 comprising the steps of:

a. directing the laser beam in the lens of the eye in a predetermined shot pattern, said shot pattern comprising as series of shots that form a grid cut pattern;

b. removing the lens material; and

,

c. replacing the lens material.

8. A method for delivering a laser beam to a lens of an eye comprising:

a. providing a laser;

b. determining the shape and position of the lens with respect to a fixed point;

c. directing the laser beam in the lens of the eye in a pattern of shots;

d. the shot pattern based in part upon the geometry of a natural human lens;

e. focusing a shot of the shot pattern in the lens of the eye based in part upon the determinations of step b.

9. The method of claim 8 comprising the step of directing the laser beam in the lens of the eye in a predetermined shot pattern, said shot pattern comprising as series of shots that form a shell cut, said shell cut being positioned entirely within the lens and essentially following a layer shape of the lens.

10. The method of claim 8 comprising the step of directing the laser beam in the lens of the eye in a predetermined shot pattern, said shot pattern comprising as series of shots that form a partial shell cut, said partial shell cut being positioned entirely within the lens and essentially following a layer shape of the lens.

11. The method of claim 8 comprising the step of directing the laser beam in the lens of the eye in a predetermined shot pattern, said shot pattern comprising as series of shots that form a laser suture cut, said cut being positioned entirely within the lens, and essentially following a layer shape of the lens.

12. The method of claim 8 comprising the step of directing the laser beam in the lens of the eye in a predetermined shot pattern, said shot pattern comprising as series of shots that form a volumetric shaped removal, said volumetric shaped removal being positioned entirely within the lens and essentially following a layer shape of the lens.

13. The method of claim 8 comprising the step of directing the laser beam in a shot patter to from an annular ring shaped capsulorhexis.

14. The method of claim 8 comprising the steps of:

a. directing the laser beam in the lens of the eye in a predetermined shot pattern, said shot pattern comprising as series of shots that form a grid cut pattern;

b. removing the lens material; and

,

c. replacing the lens material.

15. A method for creating a shell cut within a lens of an eye comprising:

a. providing a laser;

b. directing the laser beam to the lens of the eye, said lens having an outer surface and said outer surface having a shape;

c. directing the laser beam in the lens of the eye in a predetermined shot pattern, said shot pattern comprising as series of shots that form a shell cut;

d. said shell cut being positioned entirely within the lens;

e. said shell cut essentially following the shape of the outer surface of the lens.

16. The method of claim 15 wherein the shot pattern forms at least three nested shell cuts.

17. The method of claim 15 wherein the shell cut generally corresponds to a suture layer in the lens.

18. The method of claim 15 wherein the shell cut generally corresponds to a suture layer of the lens selected from the group consisting of suture layers having 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, and fractions between 3 and 15 sutures.

19. The method of claim 15 comprising the step of directing the laser beam in the lens of the eye in a predetermined shot pattern, said shot pattern comprising as series of shots that form a partial shell cut, said partial shell cut being positioned entirely within the lens and essentially following a layer shape of the lens.

20. The method of claim 15 comprising the step of directing the laser beam in the lens of the eye in a predetermined shot pattern, said shot pattern comprising as series of shots that form a laser suture cut, said cut being positioned entirely within the lens, and essentially following a layer shape of the lens.

21. The method of claim 15 comprising the step of directing the laser beam in the lens of the eye in a predetermined shot pattern, said shot pattern comprising as series of shots that form a volumetric shaped removal, said volumetric shaped removal being positioned entirely within the lens and essentially following a layer shape of the lens.

22. A method for delivering a laser beam to a lens of an eye comprising:

a. providing a laser;

b. providing an optical path for directing the laser to the lens of the eye;

c. determining the position and shape of the lens with respect to a fixed point;

d. focusing the laser beam in the lens of the eye based in part upon the determinations of step c; and

,

e. directing the laser on the lens of the eye in a shot pattern, said shot pattern comprising as series of shots that form at least two shells;

f. said shells being positioned entirely within the lens; and

,

g. said shells being nested within each other.

23. A method for creating partial shell cuts within a lens of an eye comprising:

a. directing a laser beam to the lens of the eye, said lens having an outer surface and said outer surface having a shape;

b. directing the laser beam on the lens of the eye in a predetermined shot pattern, said shot pattern comprising as series of shots that form at least two partial shell cuts;

c. said partial shell cuts being positioned entirely within the lens; and

,

d. said partial shell cuts essentially following the shape of the outer surface of the lens.

24. The method of claim 23 wherein the partial shell cut generally corresponds to a suture layer in the lens.

25. The method of claim 23 wherein the partial shell cut generally corresponds to a suture layer of the lens selected from the group consisting of suture layers having 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, and fractions between 3 and 15 sutures.

26. The method of claim 23 comprising the step of directing the laser beam in the lens of the eye in a predetermined shot pattern, said shot pattern comprising as series of shots that form a shell cut, said shell cut being positioned entirely within the lens and essentially following a layer shape of the lens.

27. The method of claim 23 comprising the step of directing the laser beam in the lens of the eye in a predetermined shot pattern, said shot pattern comprising as series of shots that form a laser suture cut, said cut being positioned entirely within the lens, and essentially following a layer shape of the lens.

28. The method of claim 23 comprising the step of directing the laser beam in the lens of the eye in a predetermined shot pattern, said shot pattern comprising as series of shots that form a volumetric shaped removal, said volumetric shaped removal being positioned entirely within the lens and essentially following a layer shape of the lens.

29. The method of claim 23 wherein the partial shell cuts stacked.

30. The method of claim 23 wherein the partial shell cuts are staggered.

31. The method of claim 23 wherein the partial shell cuts are partially overlapping.

32. A method for delivering a laser beam to a lens of an eye comprising:

a. directing the laser beam to the lens of the eye, said lens having an outer surface and said outer surface having a shape;

b. directing the laser beam in the lens of the eye in a predetermined shot pattern, said shot pattern comprising as series of shots that form a volumetric shape;

c. said volumetric shape being positioned entirely within the lens; and

,

d. said volumetric shape having at least one surface having a shape that essentially follows the shape of the outer surface of the lens.

33. The method of claim 32 wherein the volumetric shape is biconvex having an anterior and a posterior curvature;

the anterior curvature essentially following an anterior suture layer shape of the lens and the posterior curvature essentially following a posterior suture layer shape of the lens.

34. The method of claim 32 wherein the volumetric shape generally corresponds to a suture layer of the lens selected from the group consisting of suture layers having 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, and fractions between 3 and 15 sutures.

35. The method of claim 32 comprising the step of directing the laser beam in the lens of the eye in a predetermined shot pattern, said shot pattern comprising as series of shots that form a shell cut, said partial shell cut being positioned entirely within the lens and essentially following a layer shape of the lens.

36. The method of claim 32 comprising the step of directing the laser beam in the lens of the eye in a predetermined shot pattern, said shot pattern comprising as series of shots that form a partial shell cut, said partial shell cut being positioned entirely within the lens and essentially following a layer shape of the lens.

37. The method of claim 32 comprising the step of directing the laser beam in the lens of the eye in a predetermined shot pattern, said shot pattern comprising as series of shots that form a laser suture cut, said cut being positioned entirely within the lens, and essentially following a layer shape of the lens.

38. A method for providing laser created suture lines within a lens of an eye comprising:

a. directing a laser beam to the lens of the eye, said lens having an outer surface and said outer surface having a shape; and

,

b. directing the laser beam on the lens of the eye in a predetermined shot pattern, said shot pattern comprising as series of shots that form at least two laser created suture lines.

39. The method of claim 38 wherein the laser created suture line generally corresponds to a suture layer of the lens selected from the group consisting of suture layers having 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, and fractions between 3 and 15 sutures.

40. A method for creating a shell cut within a lens of an eye comprising:

a. directing a laser beam to the lens of the eye;

b. the lens of the eye comprising anterior and posterior sutures;

c. said lens comprising fibers, said fibers having a length from the anterior suture to the posterior suture;

d. directing the laser beam in the lens of the eye in a predetermined shot pattern, said shot pattern comprising as series of shots that form a shell cut; and

,

e. said shell cut having a flower like shape having a contour;

f. said contour generally following approximately the last 15% of the fiber length from the end of the fiber.

41. A method for creating a partial shell cut within a lens of an eye comprising:

a. directing a laser beam to the lens of the eye;

b. the lens of the eye comprising anterior and posterior sutures;

c. said lens comprising fibers, said fibers having a length from the anterior suture to the posterior suture;

d. directing the laser beam in the lens of the eye in a predetermined shot pattern, said shot pattern comprising as series of shots that form a partial shell cut; and

,

e. said partial shell cut having a partial flower like shape having a contour;

f. said contour generally following approximately the last 15% of the fiber length from the end of the fiber.

42. A method for removing and replacing material of a lens of an eye comprising:

a. directing a laser beam to the lens of the eye, said lens having a lens capsule, said lens having an outer surface and said outer surface having a shape;

b. directing the laser beam in the lens of the eye in a predetermined shot pattern, said shot pattern comprising as series of shots that form a grid of cubes within the outer surface of the lens;

c. cutting the material within the lens in to cubes that generally conform to the laser shot pattern; and

,

d. removing the cubed lens material from the lens capsule; and

,

e. replacing the removed cubed lens material with a lens replacement.

43. A method for modifying the gradient index of a lens of an eye comprising:

a. providing a laser;

b. directing the laser beam to the lens of the eye, said lens having an outer surface and said outer surface having a shape;

c. directing the laser beam in the lens of the eye in a predetermined shot pattern, said shot pattern comprising as series of shots that form at least two shapes of different densities;

d. said shapes being nested and positioned entirely within the lens;

e. said shapes essentially following the shape of the outer surface of the lens.

44. A system for treating conditions of the lens comprising:

a. a laser;

b. laser focusing optics;

c. a scanner;

d. a control system; and

,

e. the control system comprising a plurality of means for directing in cooperation with the laser, the scanner and the laser focusing optics, a laser shot pattern;

f. said plurality of means, comprising;

i. a means for performing a lens material extraction;

ii. a means for treating presbyopia; and

,

iii. a means for treating refractive error.

45. A system for treating conditions of the lens comprising:

a. a laser;

b. laser focusing optics;

c. a scanner;

d. a control system; and

,

e. the control system comprising a means for providing a shell cut pattern, which follows the shape of a layer of the lens.

46. A system for treating conditions of the lens comprising:

a. a laser;

b. laser focusing optics;

c. a scanner;

d. a control system; and

,

e. the control system comprising a means for providing a partial shell cut pattern, which follows the shape of a layer of the lens.

47. A system for treating conditions of the lens comprising:

a. a laser;

b. laser focusing optics;

c. a scanner;

d. a control system; and

, e. the control system comprising a means for providing a grid cut pattern.

48. A system for delivering a laser beam to a lens of an eye comprising:

a. a laser for producing a laser beam;

b. a scanner;

c. an optical path for directing a laser beam from the laser to the lens of the eye;

d. a means for determining the shape and position of the lens with respect to a fixed point; and

,

e. a control system for;

i. focusing a laser beam to a location in the lens of the eye; and

,

ii. said location being based at least in part information provided by the determining means.

49. A system for delivering a laser beam to a lens of an eye comprising:

a. a laser for producing a laser beam;

b. a scanner;

c. focusing optics;

d. means for determining the shape and position of the lens with respect to a fixed point; and

,

e. a control system capable of;

i. directing the laser beam in the lens of the eye in a pattern of shots, the shot pattern based in part upon the geometry of a natural human lens; and

,

ii. focusing a shot of the shot pattern in the lens of the eye based in part upon information provided by the determining means.

50. A system for creating a shell cut within a lens of an eye comprising:

a. a laser for producing a laser beam;

b. a scanner;

c. focusing optics;

d. a control system for directing the laser beam to the lens of the eye in a shot pattern, said shot pattern comprising as series of shots that form a shell cut, said shell cut being positioned entirely within the lens and essentially following a shape of the lens.

51. A system for delivering a laser beam to a lens of an eye comprising:

a. a laser for producing a laser beam;

b. a scanner;

c. focusing optics;

d. a control system for directing the laser beam to the lens of the eye in volumetric shape shot pattern having at least one surface having a shape that essentially follows the shape of a shape of the lens.

52. A system for delivering a laser beam to a lens of an eye comprising:

a. a laser for producing a laser beam;

b. a scanner;

c. focusing optics;

d. an optical path for directing the laser to the lens of the eye;

e. means for determining the position and shape of the lens with respect to a fixed point;

f. means for focusing the laser beam in the lens of the eye based in part upon information obtained by the means for determining; and

,

g. means for directing the laser on the lens of the eye in shot pattern, said shot pattern comprising as series of shots that form at least two shells, said shells positioned within the lens and nested within each other.

53. A system for creating partial shell cuts within a lens of an eye comprising:

a. a laser for producing a laser beam;

b. a scanner;

c. focusing optics;

d. a control system capable of directing a laser beam to the lens of the eye in a predetermined shot pattern, said shot pattern comprising as series of shots that form at least two partial shell cuts positioned entirely within the lens following the shape of a layer of the lens.

54. A system for creating partial shells within a lens of an eye comprising:

a. a laser for producing a laser beam;

b. a scanner;

c. focusing optics;

d. a control system capable of directing the laser beam to the lens of the eye in a predetermined shot pattern, said shot pattern comprising as series of shots that form at plurality of partial shell cuts positioned in a partially overlapping relationship to each other.

55. A system for providing laser created suture lines within a lens of an eye comprising:

a. a laser for producing a laser beam;

b. a scanner;

c. focusing optics;

d. a control system capable of directing a laser beam to the lens of the eye in a predetermined shot pattern, said shot pattern comprising as series of shots that form at least two laser created suture lines.

56. A system for creating a shell cut within a lens of an eye comprising:

a. a laser for producing a laser beam;

b. a scanner;

c. focusing optics;

d. a control system for directing the laser beam to the lens of the eye in a predetermined shot pattern, said shot pattern comprising as series of shots that form a shell cut, said shell cut having a flower like shape having a contour that generally follows approximately the last 15% of the fiber length from the end of the fiber.

57. A system for creating a partial shell cut within a lens of an eye comprising:

a. a laser for producing a laser beam;

b. a scanner;

c. focusing optics;

d. means for directing the laser beam to the lens of the eye in a predetermined shot pattern, said shot pattern comprising as series of shots that form a partial shell cut, said partial shell cut having a partial flower like shape having a contour generally following approximately the last 15% of the fiber length from the end of the fiber.

58. A system for removing material of a lens of an eye comprising:

a. a means for directing a laser beam to the lens of the eye, said lens having a lens capsule; and

,

b. means for directing the laser beam in the lens of the eye in a predetermined shot pattern, said shot pattern comprising as series of shots that form a grid of cubes within the outer surface of the lens.

59. A system for delivering a laser to an eye and for obtaining stereo images of the eye comprising:

a. a laser;

b. focusing optics;

c. a camera; and

,

e. a scanner optically associated with the laser and the camera;

wherein the scanner has the capability to provide stereo pairs of images of the eye and deliver a laser beam from the laser to the eye.

60. A system for delivering a laser to an eye and for determining the position of the eye comprising:

a. a patient support;

b. a laser;

optics for delivering a laser beam;

c. a control system for delivering the laser beam to the lens of the eye in a particular pattern;

d. a lens position determination apparatus; and

,

e. a laser patient interface.

61. A system for determining the position and shape in three-dimensions of components of an eye comprising:

a. a scanner;

b. a camera;

c. a processor;

d. an illumination source;

e. an eye interface device;

f. the scanner optically associated with the eye interface device, such that when the eye is illuminated by the illumination source, light will travel from the eye through the eye interface device to the scanner;

g. the scanner optically associated with the camera, such that the scanner has the capability to provide stereo pairs of images of the eye to the camera;

h. the camera associated with the processor, wherein the camera is capable of providing digital images of the eye to the processor; and

,

i. the processor having the capability to determine, based in part upon the digital images provided from the camera, the shape and position of components of the eye.